ノロアピネフリンに耐性のあるセプティックショックに対するテルリプレシン
Lancet (London, England)
|April 17, 2002
まとめ
ヴァソプレシンアナログであるテルリプレシンは,8人の患者で耐火性 сепティックショックを効果的に治療しました. この救助療法により,血圧が回復し,血管圧縮剤の使用が減少し,一部患者は集中治療室から退院することができました.
科学分野:
- クリティカルケア・メディシン
- 薬理学 薬理学とは
背景:
- ノルアピネフリン耐性低血圧によるセプティックショックには高い死亡率があります.
- ヴァソプレシン注入は死亡率を低減する可能性があるが,リバウンド低血圧を引き起こす可能性があり,長期間の投与が必要である.
- カテコアミン耐性 септикショックに対する治療の選択肢は限られている.
研究 の 目的:
- コルチコステロイドとメチレンブルーに反応しないセプティックショック患者の救命療法としてのテルリプレシンの有効性を評価する.
- テリプレシン投与後,血圧応答の持続時間と血管圧縮剤の減少の必要性を評価する.
主な方法:
- 敗血症ショックを患った8人の患者の遡及的症例シリーズ.
- テリプレシンの単発ボラスを投与する.
- 血圧反応のモニタリング,ノレピネフリン需要,および臨床結果.
主要な成果:
- 8人の患者全員が,単一のテルリプレシンボルス投与後,少なくとも5時間持続する血圧の有意な上昇を経験しました.
- ノルエピネフリン投与は7人の患者で減量または中止されました.
- 4人の患者が集中治療室から退院しました.
結論:
- テルリプレシンは,カテキオラミン耐性 сепティックショックに対する効果的な救助療法です.
- テリプレシンのボラス投与は,血圧を回復させ,血管圧縮剤への依存を軽減します.
- テルリプレシンは,この患者群では明らかな合併症のない安全な選択肢であるようです.
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